All men are at risk of having prostate problems, especially older men. These problems can range from simple inflammation to the development of cancer. About 30 million men suffer from prostate conditions and around 1 in 9 men will be diagnosed with prostate cancer during their lifetime. However, only 1 in 39 men will die from this disease.  

The prostate gland tends to grow larger with age, and it is fairly common for men in their fifties to experience some prostate issue. While not all prostate problems are life-threatening, symptoms such as pain and discomfort can negatively affect one’s quality of life.

Since most men don’t know what the prostate is or what it does, educating them on its preventable health issues can improve their chances of having a quality life after the age of 50. This article aims to provide the reader with information that may help deal with this aspect of men’s health.

What Does the Prostate Do?

The prostate gland — the same size and shape as a walnut — is part of the male reproductive system located just below the bladder. It wraps around the urethra, the tube that carries urine and semen out the body. Its primary function is to help produce fluid in semen, which carries sperm from your testicles when you ejaculate. 

Who Is at Risk for an Enlarged Prostate?

Generally, the prostate remains stable until the mid-forties, after which it begins to enlarge. The prostate grows larger as you age, and developing an enlarged one is a normal part of aging for most men.

Having an enlarged prostate (BPH) is common and may not be preventable. Your age and family history of BPH are two things that increase your chances of getting it. Here are a few stats on BPH:

• About 50% of men between ages 51 and 60 will eventually develop an enlarged prostate
• About 90% of men over the age of 85 are affected by BPH
• About 1 in 3 men will find the symptoms bothersome

Signs and Symptoms of an Enlarged Prostate

An enlarged prostate can squeeze the urethra since the prostate wraps around that tube. This can cause problems as you try to urinate. This condition is called benign prostatic hyperplasia or BPH. It is not cancerous, but it can cause pain and discomfort. 

Common signs of having an enlarged prostate are difficulty in starting to urinate and frequent urination, particularly at night. Prostate problems present with lower urinary tract symptoms (LUTS), some of which include:

• Your bladder doesn’t empty after you urinate and, rarely, bladder outlet obstruction
• Sudden urge to urinate with no sensation of buildup
• Difficulty urinating despite the urge
• Difficulty maintaining urine flow
• In some cases, loss of control over urination

If you start experiencing any of these symptoms, you should consult your doctor and check your prostate. Although rare, it may lead to serious problems such as bladder or kidney damage. Having a larger prostate doesn’t necessarily mean you will have more or worse symptoms. It varies between men. Even some men with large prostates can have few issues or experience few symptoms. Still, it would be best if you informed your doctor either way.

International Prostate Symptom Score (IPSS)

IPSS is a common method for screening and diagnosing BPH. This is a survey that asks 7 urinary symptoms questions and 1 quality of life question to help determine BPH severity. The questions consider the following:

1. Incomplete emptying;
2. Frequency of urination;
3. Intermittent urine stream;
4. The urgency to urinate;
5. Weak urine stream;
6. Straining during urination;
7. Waking up at night to urinate; and
8. Quality of life

Specific Tests

Your doctor can recommend a variety of tests to check the condition of your prostate. Here’s to name a few:

• Digital rectal exam

In this procedure, your doctor puts on a glove and gently inserts one finger into your rectum to manually check for things such as the size, shape, or any lumps on your prostate. The exam can feel invasive and a little uncomfortable. 

• Prostate-specific antigen (PSA) test

This blood test checks for the amount of a protein known as PSA, a protein produced by prostate cells. Higher levels may be a sign of cancer, but this test alone is not enough proof that you have prostate cancer.

• Prostate biopsy

This is sort of a follow-up test and is recommended for men who have high PSA levels or other symptoms of cancer. A tissue sample of your prostate is taken to confirm the presence of cancer. 

Concerns About PSA Screening

Screening for prostate cancer (PSA) has always been somewhat controversial. That’s because evidence shows that the benefits of PSA screening may not outweigh the potential harm of unnecessary treatment. One example of this is overdiagnosis since PSA tests often alert doctors to the presence of cancer, but there is no definitive way to determine whether cancers detected would have ever caused serious harm during a man’s lifetime. 

Despite this, most men with elevated PSA levels will opt for treatment to be on the safe side, which results in frequent suffering from side effects such as incontinence and impotence. That is why it is important to talk to your doctor about your options.

That said, health organizations have varying recommendations and arguments regarding PSA testing. The following are recommendations from different health organizations:

The American Cancer Society (ACS)

The ACS recommends men talk to their doctors about the benefits, risks, and limits of prostate cancer screening before deciding to be tested. Discussions about prostate screening should take place:

• At 50 for men with an average chance for prostate cancer;
• At age 45 for men with a higher chance for the condition; and
• At age 40 for men with a family history of prostate cancer (those with more than 1 first-degree relative diagnosed at an early age).

The American Urological Association (AUA)

The AUA advocates that men ages 55 to 69 who are considering screening should have an informed decision with their health care provider about the risks and benefits appropriate to their individual needs.

AUA does not recommend routine screening for:

• Men under the age of 40;
• Men who are 40 to 54 years old with average risk;
• Men older than 70; and
• Any man with less than 10-15 years life expectancy.

The U.S. Preventive Services Task Force (USPSTF)

Similar to AUA, USPSTF recommends that men ages 55 to 69 who are considering screening should have a shared-decision making with their doctor about the risks and benefits of testing. However, for men older than 70, routine PSA screening is not recommended.

Other Prostate Issures

Aside from BPH, there are two other conditions associated with the prostate. These are the following:

1. Prostatitis

This is a common condition that causes inflammation of the prostate gland. It is not the same thing as enlarged prostate, though some of the symptoms are similar. About half of all men will have prostatitis at some point in their lives and it is the most common prostate problem for men under 50. 

Prostatitis affects men of all ages and may start to occur from their late teens to well into old age. Its symptoms include: 

• Painful urination
• Chills and fever
• Painful ejaculation or pain during intercourse
• Pain in the penis, testicle, and perineum
• Blood in semen
• Erectile dysfunction

Prostatitis is not considered a disease, and it does not predispose you to prostate cancer. However, similar to cancer, inflammation from prostatitis sometimes raises the level of prostate-specific antigens (PSA) in the blood. Further tests are needed to determine the cause of elevated PSA levels.

2. Prostate Cancer

Cancer is the most potentially dangerous prostate problem and it is the second most common cause of cancer in men of all ages. It also follows lung cancer as the 2nd leading cause of cancer-related deaths in men worldwide. Prostate cancer can cause many of the same symptoms as other prostate problems, making it occasionally difficult to detect. But thanks to early screening measures, a doctor can diagnose prostate cancer even before symptoms.

Prostate cancer develops in the gland and can grow over time, but it usually stays in the prostate at first, where it is less likely to cause serious harm. While some types of prostate cancer may need minimal to no treatment as they grow slowly over time, other types are more aggressive and can metastasize rapidly. 

Early detection is important because it is more remediable in its initial stages. 

3. Sex and the Prostate

Enlarged prostate or BPH may cause sexual problems in men, such as:

• Erectile dysfunction (ED)
• Reduced sex drive
• Decreased sexual satisfaction.

Sexual problems in BPH usually result from treatment rather than the disease. BPH medications such as the finasteride (Proscar), an anti-testosterone drug, have been linked with erectile dysfunction in 3.7% of men who use it. Finasteride is also associated with diminished libido in 3.3% of men. ED may also occur after the therapy for prostate cancer including radiotherapy, hormonal therapy, and surgery. 

Final Thoughts

They say one does not need a doctor’s prescription to get good health. As you advance in age, health problems are inevitable, and so are prostate concerns for men. It is already a fact that millions are suffering from prostate problems, and some will develop prostate cancer. With this in mind, it is important to take this seriously with adequate knowledge. 

It is when you start to realize that there is no assurance of having a healthy prostate that you begin to live your daily life with a proper diet, ideal body weight, and better lifestyle. There are no shortcuts to having a healthier prostate; it starts today and starts with you. Even though some things are not under your control, there are still some things that you can do to keep this organ functioning properly.